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Mkandawire E, Bisai C, Dyke E, Dressel A, Kantayeni H, Molosoni B, Kako PM, Gondwe KW, Mkandawire-Valhmu L. A qualitative assessment of gender roles in child nutrition in Central Malawi. BMC Public Health 2022; 22:1392. [PMID: 35858910 PMCID: PMC9297552 DOI: 10.1186/s12889-022-13749-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 07/04/2022] [Indexed: 11/24/2022] Open
Abstract
Background Child malnutrition persists globally with men and women playing distinct roles to support children’s nutrition. Women frequently carry the bulk of the workload related to food, care, and health, all of which are critical factors in child nutrition. For this reason, development efforts have emphasised women ignoring the potential role of men in supporting children’s nutrition. This study sought to understand the different roles that Malawian men and women play in children’s nutrition. Methods This qualitative was conducted in rural Central Malawi as part of a baseline study in 2017 for the CARE Southern Africa Nutrition Initiative. Seventy-six participants were interviewed, including 19 men and 57 women, using focus group discussions and in-depth interviews. We sought to understand the gender distribution of men’s and women’s roles and how these roles influence child nutrition. Results We found that both men and women were involved in productive, reproductive, and community work. However, consistent with the literature, women carried a disproportionate workload in supporting child nutrition compared to men. Women’s heavier workloads often prevented them from being able to meet children’s food needs. Nevertheless, shifts in gender roles were observed in some of the sampled communities, with men taking up responsibilities that have been typically associated with women. These changes in gender roles, however, did not necessarily increase women’s power within the household. Conclusions Traditional gender roles remain prevalent in the sampled communities. Women continue to be primarily responsible for the food, care, and health of the household. Women’s heavy workloads prevent them from providing optimal care and nutrition for children. While efforts to advance gender equality by encouraging men to participate in child care and other household responsibilities appear to have had marginal success, the extent to which these efforts have successfully encouraged men to share power remains unclear. Improving gender equality and child nutrition will require efforts to redistribute gendered work and encourage men to move towards shared power with women over household decision-making and control over income.
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Affiliation(s)
- Elizabeth Mkandawire
- University of Pretoria, Old College House, University of Pretoria, Pretoria, South Africa.
| | - Clement Bisai
- CARE Malawi, Pamodzi House, Off Presidential Drive, Lilongwe, Malawi
| | | | - Anne Dressel
- University of Wisconsin-Milwaukee, College of Nursing, Cunningham Hall, Milwaukee, WI, 53201, USA
| | - Hazel Kantayeni
- CARE Malawi, Pamodzi House, Off Presidential Drive, Lilongwe, Malawi
| | - Billy Molosoni
- CARE Malawi, Pamodzi House, Off Presidential Drive, Lilongwe, Malawi
| | - Peninnah M Kako
- University of Wisconsin-Milwaukee, College of Nursing, Cunningham Hall, Milwaukee, WI, 53201, USA
| | - Kaboni W Gondwe
- University of Wisconsin-Milwaukee, College of Nursing, Cunningham Hall, Milwaukee, WI, 53201, USA
| | - Lucy Mkandawire-Valhmu
- University of Wisconsin-Milwaukee, College of Nursing, Cunningham Hall, Milwaukee, WI, 53201, USA
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Robinson JC, Luebke J, Hoffman SJ, Moore KM, Kako PM, Mkandawire-Valhmu L. Commentary on "Burnout and the Sexual Assault Nurse Examiner: Who is Experiencing Burnout and Why?". J Emerg Nurs 2022; 48:123-125. [PMID: 35115183 DOI: 10.1016/j.jen.2022.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 01/10/2022] [Indexed: 10/19/2022]
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Ndakuya-Fitzgerald F, Kako PM, Dressel AE. The built environment and perceived HIV risk among young women living in the peri-urban slum of Kibra, Nairobi, Kenya. Health Place 2021; 72:102709. [PMID: 34749284 DOI: 10.1016/j.healthplace.2021.102709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 07/14/2021] [Accepted: 10/31/2021] [Indexed: 11/18/2022]
Abstract
This study reports on the lived experiences of young women living in a peri-urban slum in Kenya and its impact on perceived HIV risk and prevention needs. Guided by the theory of gender and power and postcolonial theory, 73 women 15-24 years of age participated in individual and focus group interviews. Results revealed that the built environment inside and outside the home such as inadequate physical space and lack of security impacted perceived HIV risk. To have meaningful and sustainable change, HIV prevention efforts must address social structures that impact daily lived experiences of young women.
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Affiliation(s)
| | - Peninnah M Kako
- University of Wisconsin-Milwaukee, College of Nursing, 1921 E Hartford Ave, Milwaukee WI 53211, USA
| | - Anne E Dressel
- University of Wisconsin-Milwaukee, College of Nursing, 1921 E Hartford Ave, Milwaukee WI 53211, USA
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Gondwe KW, Walker RJ, Mkandawire-Valhmu L, Dressel A, Ngui EM, Kako PM, Egede L. Predictors of wealth index in Malawi – Analysis of Malawi demographic Health Survey 2004–2015/16. Public Health in Practice 2021; 2:100059. [PMID: 36101605 PMCID: PMC9461306 DOI: 10.1016/j.puhip.2020.100059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 11/06/2020] [Accepted: 11/17/2020] [Indexed: 12/01/2022] Open
Abstract
Objectives To examine the wealth index over a decade utilizing Malawi’s Demographic and Health (DHS) survey data from 2004, 2010, and 2015/16, and to explore factors that predict higher wealth. Study design This was a retrospective descriptive study. Methods The study utilized DHS data from 2004, 2010, and 2015/2016. The total number of participants was 77,194. Linear regression models were used to assess the effects of the predictors. All analyses were conducted in Stata version 13. Results Findings showed no significant increase in wealth between the survey years. However, significant increases in wealth were associated with smaller family size (−0.09[-0.10, −0.08]), age (0.02[0.02,0.02]), having formal education (0.21[0.18, 0.24]), and living in urban areas (−1.84[-1.98, −1.70]). Differences in wealth also existed among the different ethnic and religious groups with the Chewa reporting less wealth than other groups, and people with any form of religion reporting more wealth than people with no religion. Conclusions Minimal changes in wealth have occurred in Malawi between 2004 and 2015/16, and sociodemographic, socioeconomic, and cultural factors are associated with wealth in this population.
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Kako PM, Ngui E, Kako T, Ndakuya-Fitzgerald F, Mkandawire-Valhmu L, Dressel AE, Kiplagat A, Egede LE. Sustaining peer support groups: Insights from women living with HIV in rural Kenya. Public Health Nurs 2021; 38:588-595. [PMID: 33778994 DOI: 10.1111/phn.12879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 01/17/2021] [Accepted: 01/18/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE As HIV transitions to a chronic disease, measures that foster continued health are critical. Peer support groups can help in reducing stigma and ensuring wellbeing for those living with HIV. The purpose of our study was to gain an understanding of the ways in which women living with HIV in rural areas sustain peer support groups. DESIGN AND SAMPLE For this descriptive qualitative study, 20 women living with HIV participated in the study. Women were randomly divided into two peer support groups of ten women each; the groups met over a 12-month period. monthly for the first two months and then every three months for the remainder of the year. RESULTS Discussion themes indicated women found ways to sustain the groups by using them as a platform for engaging in income generation; starting and participating in table banking; addressing food security; and finding financial and moral support. Problem-solving challenges of sustaining peer support groups was also a major theme. CONCLUSION As people live longer with HIV, long-term peer support will be needed to maintain wellbeing. Community-based peer support groups can be sustained by engaging women in common income-generation activities.
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Affiliation(s)
- Peninnah M Kako
- College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.,Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Emmanuel Ngui
- Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Tavonna Kako
- University of Alabama at Birmingham Medical Center, Birmingham, AL, USA
| | | | - Lucy Mkandawire-Valhmu
- College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.,Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Anne E Dressel
- College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.,Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI, USA.,Center for Global Health Equity, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.,University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Augustine Kiplagat
- College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Leonard E Egede
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI, USA.,Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
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Ngui EM, Kako PM, Dressel A, Mkandawire-Valhmu L, Walker RJ, Gondwe KW, Prigmore HL, Egede LE. The association of HIV status with rural-urban differences in wealth in Malawi: 2004-2015/16. AIDS Care 2020; 33:1451-1457. [PMID: 32835495 DOI: 10.1080/09540121.2020.1808157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This retrospective cross-sectional study examined the association of HIV status with wealth in Malawi using the 2004, 2010, and 2015/16 Malawi Demographic and Health Survey (MDHS) data. A harmonized wealth index was generated using factor analysis of the pooled data. Bivariate and multivariate linear regression models were estimated to examine the association of HIV status with wealth stratified by urban and rural communities in Malawi. The sample consisted of 33,484 individuals(3,419 were HIV positive and 30,065 HIV-negative). While only 52% of the participants were female, women constituted 61% of those who were HIV positive. Findings showed a positive association between HIV status and wealth in rural but not in urban locations. In rural locations, HIV status was significantly associated with increased wealth (β=0.11; 0.07, 0.15), whereas having more children in the household (β=-0.02; -0.03, -0.02) and being employed (β=-0.07; -0.09, -0.04) were associated with decreased wealth. Given our findings of increased HIV prevalence among those with a higher wealth index in rural Malawi, broadening HIV-prevention efforts to include programs that target the wealthy in Malawi might help mitigate new HIV infections. To effectively address HIV in Malawi, HIV programming policies must target women and men at all socioeconomic status levels.
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Affiliation(s)
- Emmanuel M Ngui
- Community and Behavioral Health Promotion, Zilber School of Public Health, University of Wisconsin-Milwaukee
| | - Peninnah M Kako
- College of Nursing, University of Wisconsin-Milwaukee.,Center for Advancing Population Science, Medical College of Wisconsin
| | - Anne Dressel
- College of Nursing, University of Wisconsin-Milwaukee.,Center for Advancing Population Science, Medical College of Wisconsin
| | - L Mkandawire-Valhmu
- College of Nursing, University of Wisconsin-Milwaukee.,Center for Advancing Population Science, Medical College of Wisconsin
| | - Rebekah J Walker
- Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin.,Center for Advancing Population Science, Medical College of Wisconsin
| | - K W Gondwe
- College of Nursing, University of Wisconsin-Milwaukee.,Center for Advancing Population Science, Medical College of Wisconsin
| | - Heather L Prigmore
- Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin.,Center for Advancing Population Science, Medical College of Wisconsin
| | - Leonard E Egede
- Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin.,Center for Advancing Population Science, Medical College of Wisconsin
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Wesp LM, Scheer V, Ruiz A, Walker K, Weitzel J, Shaw L, Kako PM, Mkandawire-Valhmu L. An Emancipatory Approach to Cultural Competency: The Application of Critical Race, Postcolonial, and Intersectionality Theories. ANS Adv Nurs Sci 2019; 41:316-326. [PMID: 30285982 DOI: 10.1097/ans.0000000000000230] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Nurses teach, work, and conduct research in an increasingly hostile sociopolitical climate where health inequities persist among marginalized communities. Current approaches to cultural competency do not adequately equip nurses to address these complex factors and risk perpetuating stereotypes and discrimination. A theory-driven emancipatory approach to cultural competency will instead lead to lasting change and uphold the core nursing value of commitment to social justice. This article explicates key tenets of critical race, postcolonial feminist, and intersectionality theories and then applies them, using an emancipatory approach to cultural competency that can reshape nursing education, research, and practice.
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Kibicho J, Pinkerton SD, Owczarzak J, Mkandawire-Valhmu L, Kako PM. Are community-based pharmacists underused in the care of persons living with HIV? A need for structural and policy changes. J Am Pharm Assoc (2003) 2016; 55:19-30. [PMID: 25575148 DOI: 10.1331/japha.2015.14107] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To describe community pharmacists' perceptions on their current role in direct patient care services, an expanded role for pharmacists in providing patient care services, and changes needed to optimally use pharmacists' expertise to provide high-quality direct patient care services to people living with human immunodeficiency virus (HIV) infections. DESIGN Cross-sectional study. SETTING Four Midwestern cities in the United States in August through October 2009. PARTICIPANTS 28 community-based pharmacists practicing in 17 pharmacies. INTERVENTIONS Interviews. MAIN OUTCOME MEASURES Opinions of participants about roles of specialty and nonspecialty pharmacists in caring for patients living with HIV infections. RESULTS Pharmacists noted that although challenges in our health care system characterized by inaccessible health professionals presented opportunities for a greater pharmacist role, there were missed opportunities for greater level of patient care services in many community-based nonspecialty settings. Many pharmacists in semispecialty and nonspecialty pharmacies expressed a desire for an expanded role in patient care congruent with their pharmacy education and training. CONCLUSION Structural-level policy changes needed to transform community-based pharmacy settings to patient-centered medical homes include recognizing pharmacists as important players in the multidisciplinary health care team, extending the health information exchange highway to include pharmacist-generated electronic therapeutic records, and realigning financial incentives. Comprehensive policy initiatives are needed to optimize the use of highly trained pharmacists in enhancing the quality of health care to an ever-growing number of Americans with chronic conditions who access care in community-based pharmacy settings.
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Kako PM, Wendorf AR, Stevens PE, Ngui E, Otto-Salaj LL. Contending with Psychological Distress in Contexts with Limited Mental Health Resources: HIV-Positive Kenyan Women's Experiences. Issues Ment Health Nurs 2016; 37:2-9. [PMID: 26818927 DOI: 10.3109/01612840.2015.1058446] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study describes the psychosocial distress experiences of HIV-positive women in Kenya. In-depth narrative interviews were conducted three times over six months between 2009 and 2010 with 54 HIV-positive women living in Kenya to explore how the women perceived psychological distress and the steps they took to find support to cope with their HIV-positive diagnosis. Thematic analysis revealed that the women described psychological distress as: physical and emotional shock, worry, and hopelessness and suicidality. The women reported receiving support to cope through spiritual connections, family and friends, others coping with HIV/AIDS, and health care agencies. This study heightens awareness of the critical value of understanding culturally relevant mental health evaluations in a limited mental health access context.
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Affiliation(s)
- Peninnah M Kako
- a University of Wisconsin-Milwaukee , College of Nursing , Milwaukee , Wisconsin , USA
| | - Angela R Wendorf
- b University of Wisconsin-Milwaukee , Department of Psychology , Milwaukee , Wisconsin , USA
| | - Patricia E Stevens
- a University of Wisconsin-Milwaukee , College of Nursing , Milwaukee , Wisconsin , USA
| | - Emmanuel Ngui
- c University of Wisconsin-Milwaukee , Zilber School of Public Health , Milwaukee , Wisconsin , USA
| | - Laura L Otto-Salaj
- d University of Wisconsin-Milwaukee , Helen Bader School of Social Welfare , Milwaukee , Wisconsin , USA
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Abstract
In this critical ethnography, 72 HIV-infected women in Southern Malawi participated in 12 focus groups discussing the impact of HIV and violence. Our analysis, informed by a postcolonial feminist perspective, revealed women’s capacity to collectively engage in safety planning. We present our findings about women’s experiences based on narratives detailing how women collectively strategized safety planning efforts to mitigate the impact of violence. This study helps to fill a gap in the literature on the intersection between HIV and violence in women’s lives. Strategies discussed by the women could form a basis for safety planning interventions for women in similar circumstances.
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Kako PM, Stevens PE, Mkandawire-Valhmu L, Kibicho J, Karani AK, Dressel A. Missed Opportunities for Early HIV diagnosis: Critical Insights from Stories of Kenyan Women Living with HIV. Int J Health Promot Educ 2013; 51:10.1080/14635240.2012.750070. [PMID: 24273455 PMCID: PMC3833759 DOI: 10.1080/14635240.2012.750070] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Early HIV testing is critical to prevention and timely treatment. Missed opportunities for HIV diagnosis can result in unnecessary deaths at a time when access to antiretroviral treatment proves life saving. While HIV prevention and treatment research has increased, less research exists on women's experiences with HIV diagnosis, despite the fact that women are most affected. Insights from local women are critical in designing culturally meaningful interventions that thwart missed opportunities for early HIV diagnosis. The purpose of our study was to uncover steps women took to know their HIV diagnosis. Using narrative inquiry methodology informed by post-colonial feminism, we interviewed 40 HIV- positive women in Kenya. Five themes emerged related to uptake of HIV testing for women: (a) spouse's critical illness or death; (b) years of suffering from HIV-related symptoms; (c) sick children; (d) prenatal testing; and (e) personal desire to know one's HIV status. These findings centered on women experiences provide an important basis for health promotion interventions related to HIV prevention, earlier detection, and treatment.
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Affiliation(s)
- Peninnah M. Kako
- College of Nursing, University of Wisconsin-Milwaukee, P.O. Box 413, Milwaukee, WI 53201, USA
| | - Patricia E. Stevens
- College of Nursing, University of Wisconsin-Milwaukee, P.O. Box 413, Milwaukee, WI 53201, USA. Telephone: 414-229-5817 Fax:414-229-6474
| | - Lucy Mkandawire-Valhmu
- College of Nursing, University of Wisconsin-Milwaukee, P.O. Box 413, Milwaukee, WI 53201, USA. Telephone: 414-229-6098 Fax: 414-229-6474
| | - Jennifer Kibicho
- Center for AIDS Intervention Research (CAIR), Medical College of Wisconsin, 2071 North Summit Avenue, Milwaukee, WI 53202 ,USA. Telephone: 414-955-7700 Fax: 414-287-4206
| | - Anna K. Karani
- University of Nairobi, School of Nursing, P.O. Box 30197, GPO oo100, Nairobi, Kenya. Telephone: 254-0733-737881 Fax: 2711250
| | - Anne Dressel
- Center for Global Health Equity University of Wisconsin-Milwaukee in Milwaukee, College of Nursing, P.O. Box 413 Milwaukee, WI 53201, USA. Telephone: 414-229-3995 Fax: 414-229-6474
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Abstract
HIV-related stigma has a negative effect on women's health and can hinder interventions aimed at eradicating HIV. In Kenya, women withstand the worst of HIV-related stigma, because they are the most affected. In this longitudinal qualitative study, we explored experiences of stigma among 54 HIV-positive Kenyan women. Using Goffman's stigma definition and Foucault's social construction of stigma to analyze women's narratives, two main themes emerged: (1) women's experience of socially constructed HIV-related stigma and (2) women's resistance of socially constructed HIV-related stigma. Even though women are creative in resisting HIV-related stigma, psychological impact of stigma can hinder HIV prevention, care, treatment, and support. Interventions that empower women are critical in reducing HIV-related stigma.
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Affiliation(s)
- Peninnah M Kako
- University of Wisconsin-Milwaukee, College of Nursing, Milwaukee, Wisconsin 53201-0413, USA.
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Mkandawire-Valhmu L, Wendland C, Stevens PE, Kako PM, Dressel A, Kibicho J. Marriage as a risk factor for HIV: learning from the experiences of HIV-infected women in Malawi. Glob Public Health 2013; 8:187-201. [PMID: 23350930 DOI: 10.1080/17441692.2012.761261] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The gender inequalities that characterise intimate partner relationships in Malawi, a country with one of the highest HIV prevalence rates in the world, arguably place marriage as an important risk factor for HIV infection among women, yet few studies detail the complex interactions of marriage and risk. In order to develop HIV-prevention interventions that have lasting impacts in such communities, we need a deeper understanding of the intricacies of women's lives, how and why they are involved in marital relationships, and the implications of these relationships for HIV transmission or prevention. This article describes how women understand marriage's effects on their lives and their HIV risks. Drawing from focus group discussions with 72 women attending antiretroviral clinics in Malawi, we explore why women enter marriage, what women's experiences are within marriage and how they leave spouses for other relationships. Based on their narratives, we describe women's lives after separation, abandonment or widowhood, and report their reflections on marriage after being married two or three times. We then review women's narratives in light of published work on HIV, and provide recommendations that would minimise the risks of HIV attendant on marriage.
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Kako PM, Stevens PE, Karani AK, Mkandawire-Valhmu L, Banda A. Grappling with HIV transmission risks: narratives of rural women in eastern Kenya living with HIV. J Assoc Nurses AIDS Care 2011; 23:442-53. [PMID: 22137546 DOI: 10.1016/j.jana.2011.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2010] [Accepted: 09/14/2011] [Indexed: 11/25/2022]
Abstract
As people live longer and more productively with HIV infection, issues of agency in reducing HIV risk are particularly important for HIV-infected women living in high prevalence, underresourced countries such as Kenya. Because of their gendered lives, in that being masculine is associated with dominance and being feminine is associated with passiveness, women in rural Kenya must cope with continued HIV transmission risk even after knowing they are infected with HIV. In this narrative interview study, informed by theories of gender and postcolonial feminism, we examined personal accounts of HIV risk and risk reduction of 20 rural women in eastern Kenya who were living with HIV. From our analysis of the women's narratives, two major themes emerged: gender-based obstacles even in the context of a known HIV diagnosis, and struggles with economic pressures amid HIV risks. Implications for policy, programs, and research are discussed.
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Affiliation(s)
- Peninnah M Kako
- University of Wisconsin-Milwaukee, College of Nursing, Milwaukee, Wisconsin, USA
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Abstract
The purpose of our study was to develop an in-depth understanding of the reactions of 40 urban and rural HIV-infected Kenyan women to HIV diagnosis. We employed narrative inquiry principles to guide this qualitative cross-sectional study. We conducted individual in-depth interviews using open-ended questions in April and May 2006. In this article we focus on women's reactions to HIV diagnosis, under which four subthemes emerged: immediate intense emotions; keeping HIV status secret; acceptance of HIV diagnosis; and finding liberation in disclosure. We offer important implications for health care professionals serving women in sub-Saharan Africa from the findings of our study.
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Affiliation(s)
- Peninnah M Kako
- College of Nursing, University of Wisconsin-Milwaukee, 53201, USA.
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Mkandawire-Valhmu L, Kako PM, Stevens PE. Mentoring women faculty of color in nursing academia: Creating an environment that supports scholarly growth and retention. Nurs Outlook 2010; 58:135-41. [PMID: 20494688 DOI: 10.1016/j.outlook.2010.02.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2008] [Indexed: 11/30/2022]
Abstract
Our purposes in writing this article are to: (1) raise consciousness and prompt dialogue about issues contributing to the lack of racial/ethnic diversity among faculties of nursing, and (2) offer a vision for mentoring women faculty of color in nursing academia that is inclusive and supportive of scholarly growth and retention. Drawing from our own experiences as mentees and mentors, and bringing in literature to substantiate our argument, we examine racism and its ramifications for academic nursing and recommend strategies for opposing racism and encouraging collaborative mentorship.
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